Billing & Invoicing

Manage financial transactions, insurance claims, and taxation for both outpatients and inpatients.

OPD Billing (Outpatient)

OPD billing covers point-of-sale transactions like consultation fees, immediate diagnostic tests, and pharmacy purchases made without an admission.

Generating an OPD Invoice

  1. From the Patient Profile or Appointment, click Create Bill.
  2. Add the required Services (e.g., Initial Consultation).
  3. Apply any eligible discounts (requires Admin approval if above standard limits).
  4. Select the Payment Mode (Cash, Card, UPI) and process the payment.

Split Payments: If a patient wants to pay partially in Cash and partially via Credit Card, use the Add Multiple Payment Modes option during checkout.

IPD Billing (Inpatient Folio)

Unlike OPD, IPD billing is a running tally (Folio) that accumulates charges over the duration of the patient's stay.

  • Auto-Posting: Charges for bed rent are automatically posted to the folio at midnight. Lab tests and pharmacy indents ordered by the nurses are also automatically added to the folio.
  • Advances: You can request and log Advance Payments throughout the stay to keep the outstanding balance low.
  • Final Settlement: At discharge, the system calculates (Total Charges - Advances = Balance Due).

Insurance & TPA Workflows

For cashless patients covered by a Third-Party Administrator (TPA) or Health Insurance:

  1. During admission, capture the TPA details and Policy Number.
  2. Generate an Estimated Bill and submit it to the TPA portal for Pre-Authorization.
  3. Log the Approved Amount in the HMS once received from the TPA.
  4. At discharge, any amount exceeding the TPA approval must be paid out-of-pocket by the patient (Co-pay).

Tax Configuration (GST)

In India, most healthcare services are exempt from GST, but pharmacy items and certain cosmetic procedures are taxable.

The HMS automatically splits the invoice to show taxable vs non-taxable items and calculates CGST/SGST appropriately based on the tax brackets assigned in the Services and Inventory modules.